Provider Demographics
NPI:1174831549
Name:CASTRO, JENNIFER MARIA (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:MARIA
Last Name:CASTRO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:NICHOLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10887 N. MILITARY TRAIL, SUITE 7
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410
Mailing Address - Country:US
Mailing Address - Phone:561-537-0537
Mailing Address - Fax:561-370-6843
Practice Address - Street 1:10887 N. MILITARY TRAIL, SUITE 7
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410
Practice Address - Country:US
Practice Address - Phone:561-537-0537
Practice Address - Fax:561-370-6843
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9204368363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily